Associations between clinical and imaging findings in posterior ankle impingement syndrome: a systematic review

Baillie, Peta; Mayes, Susan Dickerson; Lam, Jason; Ferrar, Katia; Cook, Jill

doi:10.1177/02841851211008389

Cited by 3 publications

(6 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 2 A later systematic review in imaging for PAIS, performed by the same authors, pointed to the lack of control groups (with asymptomatic subjects) in the available studies, making an adequate clinical correlation impossible. 3 These authors support the clinical notion that PAIS diagnosis is very challenging and etiologic characterization almost impossible. 2 , 3 , 35 We described a number of different conditions (n = 11; Table 1 ) coexistent with a os trigonum or a Stieda process that are likely to contribute to pain and impingement.…”

Section: Discussionsupporting

confidence: 56%

“…The current medical and scientific scenario expose a low correlation among imaging findings, clinical symptoms, and surgical observations, potentially making our findings more meaningful. 2 , 3 , 35 Zwiers et al 35 described os trigonum in 23.7% and Stieda in 34.9% of their asymptomatic bilateral patients undergoing computed tomographic assessment. A higher prevalence was found in patients with PAIS (odds ratio 1.86), which somehow explained why these bone structures are traditionally pointed as PAIS-only etiology.…”

Section: Discussionmentioning

confidence: 99%

“…Although the general reproduction of impingement pain can be clearly diagnosed preoperatively by physical examination, the specific structure(s) causing symptoms are not always evident. 2 , 3 Posterior ankle and hindfoot arthroscopy (PAHA) is an established approach to treat PAIS. 5 , 15 , 37 The increased magnification, field of view, and real-time dynamics that an arthroscope provides allows assessment of other anatomic structures as potential causes of impingement, in addition to Stieda impingement.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Posterior Ankle Impingement: It’s Not Only About the Os Trigonum

Mansur,

Femino,

Chinnakkannu

et al. 2024

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

Background: Os trigonum and Stieda process are common etiologies for posterior ankle impingement syndrome (PAIS), and diagnosis is typically made by radiographs, computed tomographic, or magnetic resonance imaging. However, these static tests may not detect associated soft tissue and bony pathologies. Posterior ankle and hindfoot arthroscopy (PAHA) is dynamic, providing at least ×8 magnification with full anatomical visualization. The primary aim of this study was to report the prevalence of associated conditions seen with trigonal impingement treated with PAHA. Methods: In this retrospective comparative study, patients who underwent PAHA for PAIS due to trigonal impingement, from January 2011 to September 2016, were reviewed. Concomitant open posterior procedures and other indications for PAHA were excluded. Demographic data were collected with pre- and postoperative diagnosis, arthroscopic findings, type of impingement, location, associated procedures, and anatomical etiologies. Trigonal impingements were divided in os trigonal or Stieda and subgrouped as isolated, with flexor hallucis longus (FHL) disorders, with FHL plus other impingement, and with other impingement lesions. Results: A total of 111 ankles were studied—74 os trigonum and 37 Stieda. Isolated trigonal disorders accounted for 15.3% of PAIS (n = 17). Cases having associated conditions had a mode of 3 additional pathologies. FHL disorders were found in 69.4%, subtalar impingement in 32.4%, posteromedial ankle synovitis in 25.2%, posterolateral ankle synovitis in 22.5%, and posterior inferior tibiofibular ligament impingement in 19.8% of cases. Associated pathologies were observed in 58.6% of cases when FHL was not considered. Significant differences were noted comparing os and Stieda (isolated: 20.3% to 5.4%, P = .040; FHL plus others: 35.1% to 59.5%, P = .015). Conclusion: Trigonal bone (os trigonum or Stieda) was found to cause impingement in isolation in a small proportion of cases even when the FHL was considered part of the same disease spectrum. This should alert surgeons when considering removing trigonal impingement. Open approaches may limit the visualization and assessment of associated posterior ankle and subtalar pathoanatomy, thus possibly overlooking concomitant causes of PAIS. Level of Evidence: Level III, retrospective comparative study.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Posterior Ankle Impingement: It’s Not Only About the Os Trigonum

Mansur,

Femino,

Chinnakkannu

et al. 2024

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

show abstract

“…[24][25][26][27][28][29][30][31] Imaging studies in other pain presentations in various body parts, including the spine, [32][33][34][35] hip, [36][37][38][39] knee, 40 patellar, 41,42 and rotator cuff tendons, 43 have described "pathological" imaging findings in asymptomatic people, demonstrating that imaging findings are not consistently associated with pain. Because there have been no studies comparing imaging findings in groups with PAIS to asymptomatic controls, 44 it is plausible that similar is true and that the role of imaging in the diagnosis of PAIS is unclear.…”

Section: Introductionmentioning

confidence: 99%

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes

Baillie

Ferrar

Cook

et al. 2022

Clinical Journal of Sport Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…19 According to a very recent systematic review there is no published research comparing the imaging finding of people diagnosed with ankle impingement to asymptomatic people. 31 In this study we used SSM on 3D reconstructions of talus bones from CT images to quantitatively formulate the discriminating talus bone shape variations of a group of patients with bony ankle impingement from a nonimpinged control group. Finding such discriminating imaging features can be useful in quantitative diagnosis of bony ankle impingement.…”

Section: Introductionmentioning

confidence: 99%

Statistical shape model of the talus bone morphology: A comparison between impinged and nonimpinged ankles

Arbabi

Seevinck

Weinans

et al. 2022

Journal Orthopaedic Research

View full text Add to dashboard Cite

Diagnosis of ankle impingement is performed primarily by clinical examination, whereas medical imaging is used for severity staging and treatment guidance.The association of impingement symptoms with regional three-dimensional (3D) bone shape variaties visible in medical images has not been systematically explored, nor do we know the type and magnitude of this relation. In this cross-sectional case-control study, we hypothesized that 3D talus bone shape could be used to quantitatively formulate the discriminating shape variations between ankles with impingement from ankles without impingement, and we aimed to characterize and quantify these variations. We used statistical shape modeling (SSM) methods to determine the most prevalent modes of shape variations that discriminate between the impinged and nonimpinged ankles. Results of the compactness and parallel analysis test on the statistical shape model identify 8 prominent shape modes of variations (MoVs) representing approximately 78% of the total 3D variations in the population of shapes, among which two modes captured discriminating features between impinged and nonimpinged ankles (p value of 0.023 and 0.042). Visual inspection confirms that these two shape modes, capturing abnormalities in the anterior and posterior parts of talus, represent the two main bony risk factors in anterior and posterior ankle impingement. In conclusion, in this research using SSM we have identified shape MoVs that were found to correlate significantly with bony ankle impingement. We also illustrated potential guidance from SSMs for surgical planning.

show abstract

Associations between clinical and imaging findings in posterior ankle impingement syndrome: a systematic review

Cited by 3 publications

References 48 publications

Posterior Ankle Impingement: It’s Not Only About the Os Trigonum

Posterior Ankle Impingement: It’s Not Only About the Os Trigonum

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes

Statistical shape model of the talus bone morphology: A comparison between impinged and nonimpinged ankles

Contact Info

Product

Resources

About